Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
University of California, Los Angeles, Los Angeles, CA, USA.
Behav Res Ther. 2021 Dec;147:103990. doi: 10.1016/j.brat.2021.103990. Epub 2021 Oct 14.
Mental health applications or apps are a promising approach to reduce the pervasive unmet mental health need observed among marginalized groups. However, these groups face unique challenges to engage in and benefit from these interventions, and apps that consider issues of diversity, equity, and inclusion (DEI) may be better positioned to reach them. App evaluation frameworks emerge as crucial tools for researchers, clinicians, and users to select evidence-based apps. Nevertheless, it is unclear the extent to which existing assessment tools capture DEI factors. The present scoping review identified 68 studies that employed one or more assessment tools to evaluate a mental health app, leading to 44 unique app evaluation frameworks. Results showed that most frameworks were developed after 2015, and only 58% of them considered at least one DEI criterion. Frameworks that performed exceptionally well were those that combined multiple standardized and validated measures. This lack of consideration for DEI variables may limit the ability of app-based interventions to serve marginalized communities, or even worse, create new disparities. Therefore, we provide recommendations to improve current app evaluation frameworks' cultural robustness and clinical utility, maximizing their effectiveness when working with individuals from marginalized communities.
心理健康应用程序（apps）是一种很有前途的方法，可以减少边缘化群体中普遍存在的未满足的心理健康需求。然而，这些群体在参与和受益于这些干预措施方面面临着独特的挑战，而考虑多样性、公平性和包容性（DEI）问题的应用程序可能更有能力接触到他们。应用程序评估框架作为研究人员、临床医生和用户选择基于证据的应用程序的重要工具而出现。然而，目前还不清楚现有的评估工具在多大程度上捕捉到了 DEI 因素。本范围综述确定了 68 项研究，这些研究使用了一种或多种评估工具来评估心理健康应用程序，从而产生了 44 个独特的应用程序评估框架。结果表明，大多数框架是在 2015 年之后开发的，只有 58%的框架考虑了至少一个 DEI 标准。表现特别出色的框架是那些结合了多种标准化和验证过的措施的框架。这种对 DEI 变量的不考虑可能会限制基于应用程序的干预措施为边缘化社区服务的能力，甚至更糟糕的是，会造成新的差距。因此，我们提供了一些建议，以提高当前应用程序评估框架的文化稳健性和临床实用性，使其在与边缘化社区的个人合作时最大程度地发挥效果。
